The present invention has for its object a pre-descemetic sclero-keratectomy implant. To Applicants"" knowledge, no implant exists at the present time with reference to this recent surgical technique.
This recent surgical technique is proposed for treating glaucoma. In effect, when the glaucoma cannot be treated medically, it is necessary to intervene surgically in order to reduce the intraocular pressure.
The most current operatory technique is trabeculotomy. Said trabeculotomy consists in making an opening through the trabeculum, in order to evacuate the aqueous humor from the anterior chamber 8 towards the sub-conjunctival space. A filtration bulla then generally appears beneath the conjunctiva 3, provoked by the accumulation of said aqueous humor beneath said conjunctiva. The complications associated with this surgical technique are fairly numerous. They consist in precocious or late hypotoniae, in reductions in depth of the anterior chamber and even in the collapse thereof, in a choroidal lift. One of the most dramatic complications is the secondary rupture of said filtration bulla, which may cause an endophthalmitis.
In order to avoid opening the anterior chamber, other, so-called non-perforating surgical techniques for glaucoma have been proposed. One of these techniques is deep (so-called nonperforating) sclerectomy. It consists in incising the sclera until plumb with Schlemm""s canal 7. The aqueous humor then gushes through the trabeculum. In order to assist the flow of said aqueous humor, it has been proposed to place, in said incision (in the deep scleral bed), a collagen implant, cylindrical in shape (the anterior end of said implant, opposite Schlemm""s canal). Said implant facilitates said flow of said aqueous humor, performing the role of a wick (it transports the ocular fluids by capillarity). Results of implementation of this technique (deep sclerectomy associated with the placing of a collagen implant), of which the principle is recalled, are presented in Ophtalmologie 1995; 9:666-670. However, a great future does not seem promised for said implant, due to its shape and the nature of the material consituting it. In effect, the cylindrical shape is not the shape most adapted to the anatomy of the eye and the material usedxe2x80x94collagen of animal originxe2x80x94is no longer recommended in view of the problems associated with the Creutzfeldt-Jakob syndrome. Furthermore, said technique of deep sclerectomy does not solve the problem of obstructive glaucoma where the resistance to the flow is a consequence of the blocked trabeculum 6.